Individual provider Active NPI

David Beauchamp Eddleman, MD

  • Surgery Physician
  • Raleigh, NC
National Provider Identifier
1114927126
Registry record updated Mar 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
2005-00035 Issued in NC
Practice address
2800 Blue Ridge Rd
Suite 503
Raleigh, NC 27607-6478
Phone
(919) 782-8210
Fax
(919) 781-4650
NPI assigned
Aug 1, 2005
Last updated
Mar 29, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 2005-00035 NC Primary

Addresses

Primary practice location

2800 Blue Ridge Rd
Suite 503
Raleigh, NC 27607-6478

Mailing address

PO Box 31323
Raleigh, NC 27622-1323
Phone (919) 782-8210

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address deddleman7002@direct.unc.nchie.net Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050707000937 NC Practitioner - General SurgeryPractitioner - Surgical Oncology 5193761419 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General SurgeryAlso: Surgical Oncology
Education
Emory University School of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Carolina MG LLCGroup PAC ID 1951828847, 723 clinicians

Practice addresses (Care Compare)

3100 Duraleigh Rd
Suite 205
Raleigh, NC 27612-8105
Phone (919) 784-7874

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy68
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2005-00035NCMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Carolina MG, LLC Surgery CurrentSince Jun 1, 2025 Accepting new patients
Rex Physicians LLC Past Accepting new patients
Carolina Vascular Surgery and PastSince Dec 30, 2002 Accepting new patients
Rex Hospital, Inc. Past Accepting new patients
Wound Care Physicians PA Past Accepting new patients
Rex Hospital Inc Past Accepting new patients

Locations

300 Ashville Ave
Ste 300
Cary, NC 27518

2138 Veterans Pkwy
Clayton, NC 27520
Phone (919) 585-8000

11200 Governor Manly Way
Ste 208
Raleigh, NC 27614

2800 Blue Ridge Rd
Ste 300
Raleigh, NC 27607
Phone (919) 784-7810

3100 Duraleigh Rd
Ste 205
Raleigh, NC 27612
Phone (919) 238-5001

4420 Lake Boone Trl
Raleigh, NC 27607
Phone (919) 784-3034

4420 Lake Boone Trl
#200
Raleigh, NC 27607
Phone (919) 784-6818

509 N Brightleaf Blvd
Smithfield, NC 27577
Phone (919) 934-8171

Interoperability endpoints

  • Direct secure messaging: deddleman7002@direct.unc.nchie.net

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1122854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616976000000",
    "number": "1114927126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 31323",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276221323",
            "telephone_number": "919-782-8210",
            "fax_number": "919-781-4650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 BLUE RIDGE RD",
            "address_2": "SUITE 503",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276076478",
            "telephone_number": "919-782-8210",
            "fax_number": "919-781-4650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDDLEMAN",
        "first_name": "DAVID",
        "middle_name": "BEAUCHAMP",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-01",
        "last_updated": "2021-03-29",
        "certification_date": "2021-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NC",
            "license": "2005-00035",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "deddleman7002@direct.unc.nchie.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "2800 Blue Ridge Rd Ste 300",
            "city": "Raleigh",
            "state": "NC",
            "country_code": "US",
            "postal_code": "276076476",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.